When a ligament or tendon becomes detached from the bone, surgery is usually required to re-secure the ligament or tendon. Often, a substitute ligament or graft is attached to the bone to facilitate regrowth and permanent attachment. The reattachment procedure involves drilling of a graft tunnel between two bones (for example, the tibia and the femur) and securing the substitute ligament or graft in the tunnel.
To achieve optimal results, it is important that the graft tunnel be drilled at a particular angle and location through the tibia and femur. In addition, special attention is required when tensioning a substitute ligament or graft. In particular, proper tensioning of the graft prior to fixation decreases elongation of the graft once it is in place. The tension of the graft prior to fixation must be sufficient in order to achieve stability, but not so excessive that it captures the joint. Tensioning of the graft after the graft is partially in place in the tibial tunnel is also cumbersome.